Pediatric Radiotherapy: Background and Current Paradigms

  • Ryan P. Lee
  • Christopher L. Tinkle
  • John T. LucasJr
  • Thomas E. Merchant
  • Frederick A. Boop
Living reference work entry

Abstract

Traditional photon-based radiation therapy (RT) is an integral component to the treatment of pediatric central nervous system tumors. In combination with advances in surgical management, chemotherapeutic regimens, and small molecule inhibitors, RT has helped improve survival and cure rates substantially. However, successful treatment and long-term survival have revealed many late-appearing adverse effects from irradiating normal tissue. With increased recognition of these sequelae, treatment approaches have become more sophisticated, integrating new technologies and strategies aimed at reducing dose to nontarget areas. The use of proton-based RT has been gaining traction recently as one such approach, along with image guidance radiation therapy (IGRT). In the era of personalized medicine, the molecular revolution in pediatric oncology has better stratified disease subgroups, allowing for appropriate radiotherapeutic escalation or de-escalation depending on biological insights, more accurate prognosis, and the success of other interventions. In this chapter, we review basic concepts in radiation oncology, recent advances in the field, and the current treatment paradigms for the most common pediatric CNS tumors. In particular, the authors discuss medulloblastoma, ependymoma, intracranial germ cell tumors, suptratentorial premative neuroectodermal tumors (sPNET), intradural spinal cord tumors, and low-grade gliomas.

Keywords

Radiotherapy Neuro-oncology Neurosurgery Pediatrics Radiation oncology Brain tumor 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Ryan P. Lee
    • 1
  • Christopher L. Tinkle
    • 2
  • John T. LucasJr
    • 2
  • Thomas E. Merchant
    • 2
  • Frederick A. Boop
    • 3
  1. 1.University of Tennessee Health Science CenterMemphisUSA
  2. 2.Department of Radiation OncologySt. Jude Children’s Research HospitalMemphisUSA
  3. 3.Department of NeurosurgeryLe Bonheur Children’s HospitalMemphisUSA

Section editors and affiliations

  • Concezio Di Rocco
    • 1
  1. 1.Director of Pediatric NeurosurgeryInternational Neuroscience InstituteHannoverGermany

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